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NPI Code Detail

MEDICARE: DR. JORGE ANIBAL ALLENDE JR. M.D.

MEDICARE: DR. JORGE ANIBAL ALLENDE JR. M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianC50896CA
2208000000XPediatrics PhysicianC50896CA
3208M00000XHospitalist PhysicianC50896CA

General Provider Information

NPI Number : 1619970068
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JORGE ANIBAL ALLENDE JR. M.D.
Provider Business Mailing Address
First Line : 333 LAWS AVE
Second Line :
City : UKIAH
State : CA
Zip : 95482-6540
Country : US
Telephone Number : 707-468-1010
Fax Number : 707-462-7532
Provider Business Practice Location Address
First Line : 333 LAWS AVE
Second Line :
City : UKIAH
State : CA
Zip : 95482-6540
Country : US
Telephone Number : 707-468-1010
Fax Number : 707-462-7532
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2005
Last Update Date : 05/25/2022

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